Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients

Red blood cell (RBC) transfusions are a life-saving intervention, with nearly 14 million RBC units transfused in the United States each year. However, the safety and efficacy of this procedure can be influenced by variations in the collection, processing, and administration of RBCs. Procedures or manipulations that increase potassium (K+) levels in stored blood products can also predispose patients to hyperkalemia and transfusion-associated hyperkalemic cardiac arrest (TAHCA). In this mini review, we aimed to provide a brief overview of blood storage, the red cell storage lesion, and variables that increase extracellular [K+]. We also summarize cases of TAHCA and identify potential mitigation strategies. Hyperkalemia and cardiac arrhythmias can occur in pediatric patients when RBCs are transfused quickly, delivered directly to the heart without time for electrolyte equilibration, or accumulate extracellular K+ due to storage time or irradiation. Advances in blood banking have improved the availability and quality of RBCs, yet, some patient populations are sensitive to transfusion-associated hyperkalemia. Future research studies should further investigate potential mitigation strategies to reduce the risk of TAHCA, which may include using fresh RBCs, reducing storage time after irradiation, transfusing at slower rates, implementing manipulations that wash or remove excess extracellular K+, and implementing restrictive transfusion strategies.

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An Overview of Systematic Reviews: Complementary Therapies for Cancer Patients

Integrative Cancer Therapies ◽

10.1177/1534735419890029 ◽

2019 ◽

Vol 18 ◽

pp. 153473541989002 ◽

Cited By ~ 5

Author(s):

Seong Min Lee ◽

Ho Cheol Choi ◽

Min Kyung Hyun

Keyword(s):

Side Effects ◽

Cancer Patients ◽

Systematic Reviews ◽

Complementary Therapies ◽

The United States ◽

Assessment Tools ◽

Cochrane Library ◽

Future Research ◽

Cancer Type

Introduction: This article critically examines the systematic reviews (SR) and meta-analysis (MA) of complementary therapies for cancer patients to appraise the evidence level, and offers suggestions for future research and practice. Methods: The Cochrane Library and MEDLINE were searched from their inception to January 2018, to identify SR and MA of complementary therapies available for cancer patients. Final selected SR and MA were methodologically evaluated for their quality by applying the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR2) instrument. Data extraction and risk of quality assessments were performed by 2 independent reviewers. Results: A total of 104 studies were included in the analysis. The majority of the individual clinical trials included in the SR and MA were performed in China (48%) and the United States (26.9%). Breast cancer was the most studied cancer type (25%), and acupuncture was the most studied intervention (21%). Side effects of cancer such as pain, depression, and fatigue were effectively managed with complementary therapies. The methodologically problematic items included not listing the excluded studies and lack of protocol or protocol registration. Conclusions: With increasing interest in research, complementary therapies appear to be beneficial in reducing side effects and raising the quality of life of cancer patients. Complementary therapies have generally been studied for all cancers, with acupuncture being the most researched, regardless of the cancer type. Since AMSTAR2 is a stricter assessment tool than before, future studies need to consider the risk of methodological bias with caution and discuss appropriate overall quality assessment tools.

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The Scarcity of Literature on the Psychological, Social, and Emotional Effects of Gastroparesis in Children

Children ◽

10.3390/children7090115 ◽

2020 ◽

Vol 7 (9) ◽

pp. 115

Author(s):

Tiffany H. Taft ◽

Bethany Doerfler ◽

Emily Edlynn ◽

Linda Nguyen

Keyword(s):

Pediatric Patients ◽

Significant Risk ◽

Future Research ◽

Social And Emotional ◽

Current State ◽

Increased Risk ◽

Psychosocial Impacts ◽

Future Research Directions ◽

State Of Research

Gastroparesis (GP) is a chronic, gastric dysmotility disorder with significant morbidity and mortality. The hallmark of GP is the delayed emptying of the contents of the stomach in the absence of any mechanical obstruction. Patients most commonly report chronic symptoms of nausea, vomiting, feeling full quickly when eating, bloating, and abdominal pain. Treatments are limited with relatively poor efficacy. As such, children with GP are at significant risk for the development of psychological co-morbidities. In this paper, we provide a topical review of the scientific literature on the psychological, social, and emotional impacts of gastroparesis in pediatric patients. We aim to document the current state of research, identify gaps in our knowledge with appropriate recommendations for future research directions, and highlight the unique challenges pediatric patients with GP and their families may face as they manage this disease. Based on the current review, research into the psychosocial impacts in children with GP is essentially non-existent. However, when considering research in children with other chronic digestive diseases, children with GP are likely to face multiple psychosocial challenges, including increased risk for anxiety and depression, stigma, and reduced quality of life. These significant gaps in the current understanding of effects of GP across domains of childhood functioning allow for ample opportunities for future studies to address psychosocial outcomes.

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Commentary: Race and Ethnicity in Biomedical Research – Classifications, Challenges, and Future Directions

Ethnicity & Disease ◽

10.18865/ed.28.4.561 ◽

2018 ◽

Vol 28 (4) ◽

pp. 561-564 ◽

Cited By ~ 4

Author(s):

Dame Idossa ◽

Narjust Duma ◽

Katerina Chekhovskiy ◽

Ronald Go ◽

Sikander Ailawadhi

Keyword(s):

Biomedical Research ◽

Race And Ethnicity ◽

The United States ◽

Future Research ◽

Future Directions ◽

Data Collection Process ◽

Large Databases ◽

Future Research Directions ◽

Racial Ethnic

The use of race and ethnicity in biomedical research has been a subject of debate for the past three decades. Initially the two major race categories were: White and Black, leaving other minorities uncounted or inappropriately misclassified. As the science of health disparities evolves, more sophisticated and detailed information has been added to large databases. Despite the addition of new racial classifications, including multi-racial denominations, the quality of the data is limited to the data collection process and other social misconceptions. Although race is viewed as an imposed or ascribed status, ethnicity is an achieved status, making it a more challenging variable to include in biomedical research. Ambiguity between race and ethnicity often exists, ultimately affecting the value of both variables. To better understand specific health outcomes or disparities of groups, it is necessary to collect subgroup-specific data. Cultural perceptions and practices, health experiences, and susceptibility to disease vary greatly among broad racial-ethnic groups and requires the collection of nuanced data to understand. Here, we provide an overview of the classification of race and ethnicity in the United States over time, the existing challenges in using race and ethnicity in biomedical research and future research directions. Ethn Dis. 2018;28(4):561-564; doi:10.18865/ed.28.4.561.

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QOLP-02. HEALTH-RELATED QUALITY OF LIFE (HRQOL) AMONG PEDIATRIC PATIENTS WITH NEUROFIBROMATOSIS TYPE 1 (NF1) AND PLEXIFORM NEUROFIBROMA (PN) IN THE UNITED STATES: PERSPECTIVES OF THE PATIENTS AND CAREGIVERS

Neuro-Oncology ◽

10.1093/neuonc/noab196.723 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi182-vi183

Author(s):

Xiaoqin Yang ◽

Hyun Kyoo Yoo ◽

Suvina Amin ◽

Wendy Cheng ◽

Heather Sipsma ◽

...

Keyword(s):

Quality Of Life ◽

Upper Extremity ◽

Pediatric Patients ◽

Plexiform Neurofibroma ◽

The United States ◽

Measurement Information ◽

Patient Reports ◽

Patient Reported ◽

Treatment Naïve

Abstract BACKGROUND PNs occur in 30-50% of pediatric patients with NF1, often resulting in debilitating pain, mobility limitations, significant disfigurement, and may be life-threatening. Real-world evidence on the HRQoL of pediatric NF1 PN patients is limited. METHODS Patients ages 8-18 years with NF1 PN (treatment-naïve/new on selumetinib [≤ 1 month of use]) and their caregivers were recruited through Children’s Tumor Foundation to participate in an online cross-sectional survey (12/2020-1/2021). HRQoL measures included Pediatric Quality of Life Inventory (PedsQL; Acute version), Pain Interference Index (PII), and Patient-Reported Outcomes Measurement Information System (PROMIS) mobility and upper extremity functioning subscales. Patients provided self-reported responses; caregivers provided proxy responses and patient characteristics. Agreement between patient-reports and caregiver proxies was assessed using intra-class correlation coefficients (ICCs). RESULTS 61 patient-caregiver dyads participated in the survey. Patients were mostly white/Caucasian (90.2%), 50.8% female, with a median (range) age of 13.0 (11-16) years. Most were treatment-naïve (96.7%), with NF1 and PN diagnosis for > 5 years (91.8%, 82.0%). On the PedsQL (range: 0-100; higher=better; healthy patient mean scores typically > 80), patient-reported mean scores were 50.3, 56.1, 60.7, and 63.7 for school, emotional, social, and physical functioning; mean total score= 58.5. Caregiver-proxy mean scores ranged from 49.9-61.5 across subscales; mean total score= 55.4. Among patients reporting pain in the last 7 days, PII mean scores (range: 0-6; higher=more interference) were 3.0 (patient-reports) and 2.9 (caregiver proxies). Among patients with movement difficulty in the past 7 days, mean PROMIS scales t-scores (distribution mean= 50; higher=better) were 40.2 and 39.5 (patient-reports), and 35.6 and 30.1 (caregiver proxies), for mobility and upper extremity functioning. ICCs were very good, ranging from 0.85-0.93 across HRQoL measures. CONCLUSION NF1 PN can have substantial negative impact on pediatric patients, as demonstrated across various HRQoL domains, highlighting the importance of collecting patient-centered outcomes to guide treatment decisions.

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Health-related Quality of Life in Pediatric Patients With Chronic Hepatitis B Living in the United States and Canada

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0000000000001525 ◽

2017 ◽

Vol 64 (5) ◽

pp. 760-769 ◽

Cited By ~ 2

Author(s):

Sarah Jane Schwarzenberg ◽

Simon C. Ling ◽

Yona Keich Cloonan ◽

Hsing-Hua S. Lin ◽

Donna M. Evon ◽

...

Keyword(s):

Quality Of Life ◽

United States ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Pediatric Patients ◽

The United States ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Publication Trends of Research on Retinoblastoma During 2001–2021: A 20-Year Bibliometric Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.675703 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiang Gu ◽

Minyue Xie ◽

Renbing Jia ◽

Shengfang Ge

Keyword(s):

United States ◽

The United States ◽

Future Research ◽

High Survival ◽

Publication Trends ◽

H Index ◽

Related Research ◽

Number Of Publications ◽

Index Value

Background: Retinoblastoma is the most common primary intraocular malignancy of childhood. Despite high survival and eye salvage as the result of various types of therapies, retinoblastoma remains a disease that places a considerable burden on developing countries. Our study attempted to analyse the research trends in retinoblastoma research and compare contributions from different countries, institutions, journals, and authors.Methods: We extracted all publications concerning retinoblastoma from 2001 to 2021 from the Web of Science database. Microsoft Excel and VOSviewer were employed to collect publication data, analyse publication trends, and visualize relevant results.Results: A total of 1,675 publications with 30,148 citations were identified. The United States contributed the most publications (643) and citations (16,931 times) with the highest H-index value (67) as of February 4, 2021. China ranked second in the number of publications (259), while ranking fourth in both citations (2,632 times) and the H-index (26) ranked fourth. The British Journal of Ophthalmology was the most productive journal concerning retinoblastoma, and Abramson DH had published the most papers in the field. Keywords were categorized into three clusters; tumor-related research, clinical research, and management-related research. The keywords “intravitreal,” “intraarterial,” and “intravenous” appeared the most frequently, with the average appearing year being 2018.1, 2017.7, and 2017.1, respectively. Management-related research has been recognized as a heavily researched topic in the field.Conclusion: We conclude that the United States, China, and India made the most exceptional contributions in the field of retinoblastoma research, while China still has a disparity between the quantity and quality of publications. Management-related research, including intravitreal, intraarterial, and intravenous chemotherapy was considered as a potential focus for future research.

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Know Your Enemy: How Unauthorized Repatriated Migrants Learn About and Perceive Anti-Immigrant Mobilization in the United States

MIGRATION LETTERS ◽

10.33182/ml.v12i2.248 ◽

2015 ◽

Vol 12 (2) ◽

pp. 137-151 ◽

Cited By ~ 1

Author(s):

Matthew Ward ◽

Daniel E Martinez

Keyword(s):

United States ◽

The United States ◽

Border Crossing ◽

Knowledge Networks ◽

Future Research ◽

Related Information ◽

Mexico Border ◽

Original Survey ◽

The U.S

Recently scholars have turned their attention towards a growing anti-immigrant movement in the United States. In particular, residents called ‘minutemen’ have garnered attention for their vigilante patrols of the U.S.-Mexico border. Yet, there remains an absence of rigorously collected data from the unauthorized migrants they target. Filling this void, we draw on original survey data from wave 1 of the Migrant Border Crossing Study (MBCS) and address three questions: Among unauthorized repatriated migrants who have heard of minutemen, from where do they get their information? What qualities or characteristics do unauthorized repatriated migrants ascribe to minutemen? And, finally, how accurate are these perceptions? In so doing, we detail the composition of unauthorized repatriated migrants’ knowledge networks and the role these played in diffusing knowledge about minutemen. Additionally, we illuminate disparities in the quality of the minuteman-related information these networks diffuse. We find that respondents relied heavily on media outlets in the United States and Mexico to obtain information about minutemen. Social networks and the crossing experience itself mattered to a much lesser extent. Interestingly, unauthorized repatriated migrants were mixed in their perceptions of exactly who minutemen were, and migrants varied greatly in their ability to accurately identify minutemen. We conclude with implications and directions for future research.

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Improving the Quality of Rural Nursing Care

Annual Review of Nursing Research ◽

10.1891/0739-6686.26.1.175 ◽

2008 ◽

Vol 26 (1) ◽

pp. 175-194 ◽

Cited By ~ 6

Author(s):

Kathleen Cox ◽

Irma Mahone ◽

Elizabeth Merwin

Keyword(s):

Health Care ◽

Quality Of Care ◽

Rural Areas ◽

Ethical Issues ◽

The United States ◽

Operational Definition ◽

Future Research ◽

Quality Health Care ◽

Research Issues

The purpose of this chapter is to review the literature on quality of care in rural areas. Keywords related to rural quality of care were used to search CINAHL and MEDLINE databases for articles published between 2005 and 2007 (limited to studies occurring in the United States). The review consisted of a total of 46 articles. Limitations include inconsistent definitions of rural, the use of only articles available to the reviewers, an unclear understanding of the context of many of the studies, and lack of a clear operational definition of quality. The studies were grouped and discussed according to quality of workforce, practice, treatment, interventions, and technology in rural areas. Each study’s contribution to the understanding of quality health care in rural areas and to determining what was effective in improving staff, patient, or organizational outcomes in rural areas was considered. This chapter also offers a discussion of ethical issues and data quality in rural research. Issues for future research include a focus on patient safety, mental health issues, and the use of technology to improve quality of care in rural areas. Future research should also focus on demonstration studies of model applications. The nursing profession has a unique opportunity to conduct research that will contribute to the development of knowledge that will ultimately improve the quality of health and health care for individuals in rural communities.

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The Detroit Research on Cancer Survivors (ROCS) study: A focus on outcomes after cancer in a racially diverse patient population.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.177 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 177-177

Author(s):

Jennifer Lynn Beebe-Dimmer ◽

Terrance Lynn Albrecht ◽

Julie J. Ruterbusch ◽

Tara Baird ◽

Theresa A. Hastert ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Racial Differences ◽

The United States ◽

Incidence Rates ◽

Future Research ◽

P Value ◽

Full Time ◽

Incidence And Mortality

177 Background: Although we continue to make progress in reducing the incidence and mortality for most cancers in the United States, African Americans (AA) continue to experience higher cancer incidence rates and have worse survival than other populations. The causes of these poorer outcomes, from higher mortality to poorer quality of life, in AA cancer survivors are not well understood. The Detroit ROCS study was initiated to improve our understanding of the experience of AAs living with cancer. Methods: 1,000 AA and non-Hispanic white (NHW) patients with primary lung, female breast, prostate or colorectal cancer diagnosed on or after January 1, 2013, and/or treated at the Karmanos Cancer Institute in Detroit, MI were recruited to participate in a cohort study with planned follow-up for 4 years. At baseline, participants completed a web-based survey to gather information about their medical history, family history of cancer, treatment and medication use, behavioral risk factors and self-assessed quality of life. Statistical analyses were performed to examine racial differences in the distribution of patient characteristics including comorbid conditions, stage at diagnosis, first course treatment and reported health-related quality of life (HRQOL). Results: The majority of patients were AA (60%) and female (61%), with a median age at diagnosis of 60 years. AAs were older, more likely to report use of cigarettes and alcohol and report a greater number of comorbidities compared with NHW patients; they were less educated and less likely to be employed full time or married (all p-values < 0.001). AA patients reported poorer overall HRQOL compared with NHW patients (p-value < 0.001). Controlling for marital status and employment attenuated the observed racial differences in mean HRQOL scores across all measured domains. Conclusions: We observed significantly lower self-reported HRQOL among AA cancer survivors compared with NHW, which could be partially explained by differences in specific socioeconomic factors but interestingly, not the presence of multiple comorbidities. Future research efforts will evaluate the relative contribution of social and financial support to HRQOL in AAs.

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Wellness Among University-level Music Students: A Study of the Predictors of Subjective Vitality

Musicae Scientiae ◽

10.1177/1029864919860554 ◽

2019 ◽

pp. 102986491986055 ◽

Cited By ~ 1

Author(s):

Peter Miksza ◽

Paul Evans ◽

Gary E. McPherson

Keyword(s):

Peer Relationships ◽

Well Being ◽

The United States ◽

Music Students ◽

Future Research ◽

Subjective Vitality ◽

University Level ◽

Effects Of Stress ◽

The Impact

For many music students, the transition to university-level studies can be a time characterized by high levels of stress as they adjust to academic standards and the challenges of demanding performance assessments. Given this context, this study investigated the impact of stress on students’ well-being, specifically the facet of subjective vitality, defined in the literature as a feeling of energy and aliveness. Our focus was to explore whether certain psychosocial traits would moderate the negative effects of stress on vitality. Working from an empirically derived conceptual model, our central hypotheses were: (a) that stress and self-oriented perfectionism would be negatively related to vitality, whereas adaptability and quality of peer relationships would be positively related to vitality; and (b) that the relationship between stress and vitality would be moderated by students’ self-oriented perfectionism, adaptability, and quality of peer relationships. Participants were 293 undergraduate and graduate music majors from university schools of music and conservatoires in the United States and Australia. Findings revealed that stress was a significant negative predictor of vitality, but self-oriented perfectionism was not. In addition, both adaptability and quality of peer relationships were significant positive predictors of vitality. However, neither self-oriented perfectionism, adaptability, nor quality of peer relationships moderated the effects of stress on vitality. These findings are discussed with regard to practical recommendations for helping students deal with the stressors in their environments and potential theoretical avenues to explore through future research.

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